The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts
The Paradoxical Effects of COVID-19 on Cancer Care: Current Context and Potential Lasting Impacts
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DOI：
10.1158/1078-0432.ccr-20-2989
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发表时间：
2020-11-15
影响因子：
11.5
通讯作者：
Khasraw, Mustafa
中科院分区：
文献类型：
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作者：
Broom, Alex;Kenny, Katherine;Khasraw, Mustafa
2019冠状病毒病（COVID-19）从根本上扰乱了肿瘤学的实践，将护理转移到虚拟平台上，重新安排了成功开展临床实践和研究的物流和经济学，并在某些情况下重新定义了癌症患者应该和可以接受的治疗。自二零二零年初疫情爆发以来，癌症患者对病毒的易感性及在医疗环境中的潜在暴露对他们的影响一直备受关注。但很少有人强调COVID-19对如何提供癌症护理的重大且可能持久的后果。在这篇文章中，我们概述了关注COVID-19在大流行期间和可能在大流行之后对肿瘤学实践的影响的重要性，重点关注已经明显的关键转变，包括：转向在线咨询，临床试验和“基本护理”定义的转变，不断变化的实践经济学，以及癌症护理快速实施变化的潜在遗留影响。COVID-19正在广泛地重塑肿瘤学实践、临床试验和癌症护理的提供，这些变化可能会持续到活跃的大流行的中短期之后。因此，如果要利用COVID-19对癌症护理的积极影响并抵消其潜在的负面影响，那么大流行病带来的实践转变必须伴随着改善的培训和意识，加强的基础设施和基于证据的支持。
Coronavirus disease 2019 (COVID-19) has fundamentally disrupted the practice of oncology, shifting care onto virtual platforms, rearranging the logistics and economics of running a successful clinical practice and research, and in some contexts, redefining what treatments patients with cancer should and can receive. Since the start of the pandemic in early 2020, there has been considerable emphasis placed on the implications for patients with cancer in terms of their vulnerability to the virus and potential exposure in healthcare settings. But little emphasis has been placed on the significant, and potentially enduring, consequences of COVID-19 for how cancer care is delivered. In this article, we outline the importance of a focus on the effects of COVID-19 for oncology practice during and potentially after the pandemic, focusing on key shifts that are already evident, including: the pivot to online consultations, shifts in access to clinical trial and definitions of "essential care," the changing economics of practice, and the potential legacy effects of rapidly implemented changes in cancer care. COVID-19 is reshaping oncology practice, clinical trials, and delivery of cancer care broadly, and these changes might endure well beyond the short- to mid-term of the active pandemic. Therefore, shifts in practice brought about by the pandemic must be accompanied by improved training and awareness, enhanced infrastructure, and evidence-based support if they are to harness the positives and offset the potential negative consequences of the impacts of COVID-19 on cancer care.